EVV in Idaho: Aggregator, Approved Vendors, Reason Codes and Deadlines (2026)
Idaho Medicaid EVV explained for home care agencies: the provider-choice model, the Sandata aggregator, which services need EVV, how visits are rounded, reason codes and how to fix a denied claim.
Short answer. Idaho uses a provider-choice EVV model: agencies pick an EVV system, and it must send visits to the state’s aggregator, Sandata. EVV applies to personal care services and home health services that require an in-home visit. CMS confirmed Idaho’s compliance for both in February 2023. Check a visit before billing with the EVV visit checker.
At a glance
| Topic | Details |
|---|---|
| Aggregator | Sandata, the state aggregator |
| Model | Provider choice: any EVV system compatible with the state aggregator |
| State system | Ask Idaho Medicaid whether a state-provided option is available to you |
| Alternate vendors | Must follow the state’s technical specification for alternate EVV vendors and pass compatibility testing with Gainwell |
| Services that require EVV | Personal care services and home health services that require an in-home visit |
| Key dates | CMS letter confirming compliance for personal care and home health, February 15, 2023 |
| Who to call | Idaho Medicaid (Department of Health and Welfare); Gainwell Technologies for compatibility testing |
Which vendors are approved in Idaho?
Idaho doesn’t publish an approved-vendor list. Your EVV system must be compatible with the state’s aggregator: Idaho publishes technical specifications for alternate EVV vendors, and Gainwell Technologies, the Medicaid fiscal agent, runs compatibility testing. Confirm your vendor has passed testing before your first Medicaid visit.
Open or closed model, and what it means for you
Provider choice: caregivers clock in and out in the system your agency picks, the visit goes to the Sandata aggregator, and the claim is matched against it. If the aggregator never receives an accepted visit, the claim denies no matter how good the paper record is.
The six elements every visit must carry
Type of service, individual receiving the service, individual providing the service, date, location, and start and end time. Missing any one is a rejected visit. The usual failures: a missing clock-out, a caregiver not linked to the agency on that date, and a check-in away from the home with no reason recorded.
Rounding and units
Personal care is usually billed in 15-minute units. Idaho’s fee schedule and provider manual set the unit and the rounding rule for each service code, so check them for the codes you bill. Convert minutes with the units calculator.
Reason codes
Idaho’s exact reason codes and their wording are set in your EVV system and the Idaho Medicaid EVV guidance. These are the kinds of reasons it asks for:
| Reason | When to use it |
|---|---|
| Missed clock-in or clock-out | The caregiver forgot to check in or out; the visit is entered manually |
| Device or app problem | Phone, app or battery failed during the visit |
| No signal at the home | Location could not be captured |
| Member refused or unavailable | The member would not use the phone or device |
| Service in the community | The visit took place away from the home |
| System outage | A confirmed outage of the state or vendor EVV system |
Use the most specific reason. Payers audit free-text “Other” and repeated manual entries by the same caregiver.
Grace window
We did not find a set grace period for late clock-ins in Idaho’s EVV guidance. Small differences from the schedule usually pass; the EVV visit checker flags visits more than 15 minutes off schedule so you can add a reason first. Your health plan contract may set a tighter threshold.
Deadlines and the correction window
CMS confirmed Idaho’s EVV compliance for personal care and home health services in a letter dated February 15, 2023. Correct the visit in your EVV system, confirm the aggregator accepts it, then resubmit the claim through the Idaho Medicaid claims system run by Gainwell. Check the timely filing limit in your provider handbook.
If a claim denies for EVV
- Find the visit in your EVV system and read the rejection reason.
- Fix the element (member ID, service code, times, location) and attach the reason code.
- Confirm the aggregator shows the visit as accepted or verified.
- Resubmit the claim. Do not resubmit before step 3; it denies again.
How Caregiver Scheduling handles Idaho EVV
Caregiver Scheduling captures the six elements with geofenced GPS check-in, logs an override reason when GPS can’t confirm the location, and flags late and missed check-ins for the office. In Idaho, your EVV system has to pass compatibility testing with the state aggregator, so ask us how that works for your agency. GPS check-in and EVV.
Sources
- Idaho DHW, Long-term care provider resources (EVV)
- CMS, Idaho EVV compliance letter, February 15, 2023
Last reviewed November 6, 2026. General information, not legal or billing advice; confirm current rules with Idaho’s Medicaid agency.